Healthcare Utilization and Treatment Patterns in Diabetic Macular Edema in Korea: a Retrospective Chart Review
10.3346/jkms.2019.34.e118
- Author:
Kyu Hyung PARK
1
;
Yun Young KIM
;
Young Joon JO
;
Jaeryung OH
;
Joo Eun LEE
;
Ji Eun LEE
;
Dong Ho PARK
;
Se Woong KANG
;
Won Ki LEE
;
Ha Kyoung KIM
;
Michael ADENA
;
Jonathan TAN
;
Si Dong KIM
Author Information
1. Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
- Publication Type:Original Article
- Keywords:
Anti-VEGF;
Clinical Practice Patterns;
Intravitreal Injections;
Laser Therapy;
Visual Acuity;
Visual Outcomes
- MeSH:
Adrenal Cortex Hormones;
Cohort Studies;
Delivery of Health Care;
Demography;
Endothelial Growth Factors;
Humans;
Intravitreal Injections;
Korea;
Laser Therapy;
Macular Edema;
Ophthalmology;
Practice Patterns, Physicians';
Retrospective Studies;
Visual Acuity
- From:Journal of Korean Medical Science
2019;34(15):e118-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Limited data exist on real-world treatment patterns for diabetic macular edema (DME) in Korea. In this study, we investigated DME treatment patterns from 2009 to 2014 and the impact of baseline treatment on healthcare resource utilization and visual acuity (VA) outcomes. METHODS: A retrospective cohort chart review of DME patients treated at 11 hospital ophthalmology clinics between January 1, 2012 and December 31, 2013 was conducted. We collected data on demographics, healthcare resource utilization (clinic visits, treatment visits, and visits for ocular investigations), distribution of DME treatments, and VA. RESULTS: Overall, 522 DME patients (men, 55.2%; mean age, 59 years; mean HbA1c [n = 209], 8.4%) with 842 DME eyes were evaluated. For all treatments, healthcare resource utilization was significantly higher during the first 6 months versus months 7–12, year 2, or year 3 (P ≤ 0.001), but was highest for patients whose first treatment was an anti-vascular endothelial growth factor (VEGF) treatment (visits/quarter; anti-VEGF, 1.9; corticosteroids, 1.7; laser, 1.4). Use of macular laser therapy decreased (44% to 8%), whereas use of anti-VEGF injections increased (44% to 69%) during the study period. However, VA improvement was not commensurate with healthcare resource utilization of anti-VEGF treatment (mean VA gain, 2.7 letters). CONCLUSION: A trend toward increasing use of intravitreal anti-VEGF injections for DME treatment was observed in Korea. However, the frequency of dosing and monitoring was lower in clinical practice versus major clinical trials, which may have led to the less-than-favorable improvements in visual outcomes.
